POS1199 IS PSORIATIC ARTHRITIS A RISK FACTOR FOR SEVERE COVID -19 INFECTION? DATA FROM THE ARGENTINIAN REGISTRY SAR-COVID
Authors: V. Savio, C. Maldini, P. Alba, V. Saurit, G. Berbotto, C. Pisoni, Y. Tissera, R. Nieto, F. Maldonado, S. Ornella, C. Gobbi, A. R. Baños, F. Vivero, I. E. Exeni, A. Cusa, V. I. Bellomio, R. Perez Alamino, G. Gomez, D. Zelaya, F. Risueño, M. I. Quaglia, M. D. L. A. Correa, R. Rojas Tessel, M. Delavega, M. A. Lazaro, A. L. Mercé, P. Finucci, C. E. Matellan, C. Romeo, V. Martire, S. Moyano, M. L. Martin, E. Picco, C. Goizueta, E. R. Tralice, M. N. Tamborenea, G. C. Subils, R. Gallo, S. I. Pineda Vidal, J. L. Velasco Zamora, N. Lloves Schenone, V. Cosentino, F. Rodriguez, M. P. Diaz, M. Viola, M. L. Mamani Ortega, E. Buschiazzo, G. Gómez, K. Roberts, R. Quintana, C. A. Isnardi, G. Pons-Estel
Journal: Annals of the Rheumatic Diseases (2022)

Background Comorbidities, particularly cardio-metabolic disorders, are highly prevalent in patients with psoriatic arthritis (PsA) and they were associated with an increased risk of atherosclerotic cardiovascular disease, which have been associated with higher morbidity and mortality. Whether PsA enhances the risk of SARS-CoV-2 infection or affects the disease outcome remains to be ascertained. Objectives To describe the sociodemographic, clinical and treatment characteristics of patients with PsA with confirmed SARS-CoV-2 infection from the SAR-COVID registry and to identify the variables associated with poor COVID-19 outcomes, comparing them with those with rheumatoid arthritis (RA). Methods Cross-sectional observational study including patients ≥18 years old, with diagnosis of PsA (CASPAR criteria) and RA (ACR / EULAR 2010 criteria), who had confirmed SARS-CoV-2 infection (RT-PCR or serology) from the SAR-COVID registry. Recruitment period was between August 13, 2020 and July 31, 2021. Sociodemographic variables, comorbidities, and treatments were analyzed. To assess the severity of the infection, the ordinal scale of the National Institute of Allergy and Infectious Diseases (NIAID)1 was used, and it was considered that a patient met the primary outcome, if they presented criteria of categories 5 or higher on the severity scale. For this analysis, Chi2 test, Fisher’s test, Student’s test or Wilcoxon test, and binomial logistic regression using NIAID&gt;=5 as dependent variable were performed. Results A total of 129 PsA patients and 808 with RA were included. Clinical characteristics are shown in Table 1. Regarding PsA treatment, 12.4% of PsA were receiving IL-17 inhibitors, 5.4% IL12-23 inhibitors, one patient apremilast and one abatacept. The frequency of NIAID≥5 was comparable between groups (PsA 19.5% vs RA 20.1%; p=0.976). (Figure 1). Table 1. Characteristics of patients with PsA and RA who presented COVID-19 in the SAR-COVID registry. Psoriatic arthritis (n=129) Rheumatoid arthritis (n=808) P value Total (n=937) Age (years), mean (SD ) 51.7 (12.7) 53.1 (12.9) 0.239 52.9 (12.9) Female 72 (55.8) 684 (84.7) &lt;0.001 756 (80.7) Comorbidities 65 (50.4) 355 (43.9) 0.203 420 (44.8) Obesity (BMI ≥30 ) 19 (15.2) 102 (13.4) 0.692 121 (13.7) Morbid obesity (BMI ≥40 ) 1 (0.8) 10 (1.3) 1 11 (1.25) Hypertension 35 (28.5) 205 (26.8) 0.783 240 (27.0) Diabetes 16 (13.0) 67 (8.8) 0.188 83 (9.39) Dyslipidemia 24 (19.5) 102 (13.5) 0.106 126 (14.4) Cardiovascular or cerebrovascular disease 5 (11.4) 32 (3.9) 0.033 37 (4.2) Two or more comorbidities 55 (42.6) 219 (27.1) &lt;0.001 274 (29.2) Current smoking 4 (3.6) 60 (8.4) 0.79 64 (7.7) High disease activity 0 (0) 29 (3.8) 0.027 29 (3.23) Glucocorticoids treatment 5 (20.0) 95 (60.1) &lt;0.001 100 (54.6) Conventional DMARDs 47 (36.4) 443 (54.8) &lt;0.001 490 (52.3) Biologic DMARDs 60 (46.5) 193 (23.9) &lt;0.001 253 (27.0) JAK inhibitors 4 (3.10) 72 (8.9) 0.038 76 (8.1) Full recovery of COVID-19 105 (84.0) 644 (81.7) 0.127 749 (82.0) COVID-19 complications 16 (12.5) 68 (8.7) 0.227 84 (9.2) Death due to COVID-19 1 (0.8) 34 (4.3) 0.074 35 (3.8) Notes=values n (%) unless otherwise indicated; BMI: Body Mass Index; DMARDs: disease-modifying antirheumatic drugs; JAK inhibitors: Janus kinase inhibitors. PsA patients with NIAID≥5 in comparison with NIAID&lt;5 were older (58.6±11.4 vs 50±12.5; p=0.002), had more frequently hypertension (52.2% vs 23%; p=0.011) and dyslipidemia (39.1% vs 15%; p=0.017). In the multivariate analysis, age (OR 1.06; 95% CI 1.02–1.11) was associated with a worse outcome of the COVID-19 (NIAID≥5) in patients with PsA, while those who received methotrexate (OR 0.34; 95% CI 0.11–0.92) and biological DMARDs (OR 0.28; 95% CI 0.09–0.78) had a better outcome. Conclusion Although PsA patients have a higher frequency of cardiovascular and metabolic comorbidities than those with RA, the COVID-19 severity was similar. Most of the patients had mild SARS-CoV-2 infection and a low death rate. References [1]Beigel JH, et al. Remdesivir for the Treatment of Covid-19 - Final Report. N Engl J Med. 2020 Nov 5;383(19):1813-1826. Disclosure of Interests None declared